What constitutes long term survival after surgery for hilar cholangiocarcinoma?

Klempnauer, J.; Ridder, Gerd Jürgen; Werner, Maic; Weimann, Arved; Pichlmayr, R.

doi:10.1016/s0928-4346(97)85783-0

Cited by 18 publications

(27 citation statements)

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“…24 In the present series, the rate of postoperative complications was 37.7% when hepatectomy was performed, significantly higher than the 13.6% when it was not. Moreover, while the number of cases is still small, long-term survivors are now being documented even with bile duct resection alone, 24,25 demonstrating that extended resection is not always necessary in every patient. We have four patients with pT 1 or pT 2 tumors who underwent bile duct resection alone and survived for more than 5 years after surgery.…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment for hilar cholangiocarcinoma

Tabata

Kawarada

Yokoi

et al. 2000

Journal of Hepato-Biliary-Pancreatic Surgery

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From September 1976 to February 1998, we experienced 75 resected patients with hilar cholangiocarcinoma. Curative resection was performed in 45 patients (60.0%), with a cumulative 5-year survival rate of 39.8%. In this retrospective study, we compared therapeutic outcomes in these 75 patients according to the period during which they were treated; (1) 12 patients in the early period (September 1976 to August 1981) chiefly treated by bile duct resection, (2) 50 patients in the middle period, September 1981 to August 1994, chiefly treated by aggressive surgical procedures with extensive hepatectomy plus caudate lobe resection, and (3) 13 patients in the late period, September 1994 to February 1998, during which percutaneous transhepatic portal embolization was introduced to increase the safety and curability of extended hepatectomy, and limited hepatectomy was selected according to tumor spread. In the late period, total resection of the caudate lobe was done in all patients, with the aim being thorough resection of cancer cells in the caudate lobe. The curative resection rates were 16.7% in the early period, 64.0% in the middle period, and 84.6% in the late period, showing an improvement year-by-year (P<0.05; early period vs middle period and late period). All patients in the early period died within 2 years of resection, whereas the 5-year survival rate in the middle period was 24.4%, significantly improved (P<0.05) compared with the early period. The 1- and 3-year survival rates of 84.6% and 58.0%, respectively, in the late period, show an even greater improvement in outcome.

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Section: Discussionmentioning

confidence: 99%

Surgical treatment for hilar cholangiocarcinoma

Tabata

Kawarada

Yokoi

et al. 2000

Journal of Hepato-Biliary-Pancreatic Surgery

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“…Surprisingly, only five studies confirmed the TNM staging system as an independent prognostic factor [2,35,46Á48]. In several studies, the staging system had no predictive value for survival [3,8,21,32,33,49] and, in a few, only in univariate analysis [23,31,50].…”

Section: Surgical Complicationsmentioning

confidence: 99%

Surgery for extrahepatic cholangiocarcinoma: predictors of survival

Kloek

Kate

Busch

et al. 2008

HPB

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The incidence of extrahepatic cholangiocarcinoma is increasing worldwide and is often in an advanced stage at diagnosis and difficult to treat. The TNM (tumor node metastasis) cancer staging system predicts survival on the basis of tumor histopathology and the presence of distant metastases. However, numerous prognostic factors have been described that are not included in the TNM system. This review focuses on the prognostic significance of clinical, surgical, and histopathological factors as reported in the literature. Overall, the most important independent prognostic factors for long-term survival are negative surgical margins, lymph node status, and differentiation grade of the tumor. Further improvement of staging systems and identification of prognostic factors are crucial if we are to better select patients for surgical and adjuvant therapy and, hence, increase the rate of curative resections.

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“…Surgical therapy is the only effective curative treatment for EHCC; postoperative survival is dependent on the existence of invasion and metastasis. (3,4) Therefore, to improve patient prognoses, we must understand the mechanism of cancer progression in EHCC.Stathmin1 (STMN1) is a major cytosolic phosphoprotein that regulates microtubule dynamics by preventing tubulin polymerization and promoting microtubule destabilization. STMN1 plays an important role in a variety of biological processes, including carcinogenesis.…”

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confidence: 99%

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confidence: 99%

Stathmin1 regulates p27 expression, proliferation and drug resistance, resulting in poor clinical prognosis in cholangiocarcinoma

et al. 2014

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Patients with extrahepatic cholangiocarcinoma (EHCC) have a poor prognosis; postoperative survival depends on cancer progression and therapeutic resistance. The mechanism of EHCC progression needs to be clarified to identify ways to improve disease prognosis. Stathmin1 (STMN1) is a major cytosolic phosphoprotein that regulates microtubule dynamics and is associated with malignant phenotypes and chemoresistance in various cancers. Recently, STMN1 was reported to interact with p27, an inhibitor of cyclin-dependent kinase complexes. Eighty EHCC cases were studied using immunohistochemistry and clinical pathology to determine the correlation between STMN1 and p27 expression; RNA interference to analyze the function of STMN1 in an EHCC cell line was also used. Cytoplasmic STMN1 expression correlated with venous invasion (P = 0.0021) and nuclear p27 underexpression (P = 0.0011). Patients in the high-STMN1-expression group were associated with shorter recurrence-free survival and overall survival than those in the low-expression group. An in vitro protein-binding assay revealed that cytoplasmic STMN1 bound to p27 in the cytoplasm, but not in the nucleus of EHCC cells. Moreover, p27 accumulated in EHCC cells after STMN1 suppression. STMN1 knockdown inhibited proliferation and increased the sensitivity of EHCC cells to paclitaxel. STMN1 contributes to a poor prognosis and cancer progression in EHCC patients. Understanding the regulation of p27 by STMN1 could provide new insights for overcoming therapeutic resistance in EHCC.

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What constitutes long term survival after surgery for hilar cholangiocarcinoma?

Cited by 18 publications

References 0 publications

Surgical treatment for hilar cholangiocarcinoma

Surgical treatment for hilar cholangiocarcinoma

Surgery for extrahepatic cholangiocarcinoma: predictors of survival

Stathmin1 regulates p27 expression, proliferation and drug resistance, resulting in poor clinical prognosis in cholangiocarcinoma

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